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Montgomery County looks north
for cheaper drugs
BY DENNY CARTER
Last month, Montgomery County
joined a growing list of U.S. jurisdictions looking north
of the border for solutions to growing employee health care
concerns.
On Nov. 4, the Montgomery County Council agreed to study
a proposal to search for prescription drugs in Canada in an
effort to cut the cost of its employees’ health plan.
"Our objective is to address the needs of our employees,"
said Nancy Floreen, a member of the council. "We first
need to understand the issues and options involved."
Councilmember Tom Perez said the shipment of Canadian prescriptions
across the border is a logical alternative to the county’s
financial troubles.
"We’re in the middle of a health care and fiscal
crisis right now," he said. "There’s real money
to be saved."
Montgomery County will spend more than $60 million this year
on prescription drugs for about 38,000 active and retired
employees.
"The amount we spend every year has been a concern for
us," said Floreen. "This issue has been on our plate
for a while."
Court Rosen, a spokesman for the Pharmaceutical Research
and Manufacturers of America, said prescription drugs from
outside the country pose a threat to the people who use them.
Many of the drugs, he said, are improperly stored and are
often mislabeled.
"It is simply not possible to guarantee safety for these
prescriptions coming into the country," Rosen said. "There
have been people who have been hurt or killed by this —
this is affecting real people."
Rosen argues that U.S. states, cities and counties should
look at other alternatives to cutting health care costs. States
that have proposed the importation of Canadian prescriptions
include Iowa, Illinois, Massachusetts and Minnesota.
"The straightest argument in this situation is that
it’s illegal — the FDA doesn’t approve of any
of it."
Advocates of importation, including Perez, point out that
Canadian prescription drugs do not have any negative impact
in other countries, including Canada.
"How many stories have you read about dead Canadians
killed by prescription drugs?" he asked.
Springfield, Mass. is one city that has already initiated
this program, Rosen said.
Springfield projects that the health care savings will add
to $4 million of its current $9 million annual cost for city
employees’ prescription drugs.
On a larger scale, Illinois estimates that importing prescriptions
from north of the border could save $91 million of their annual
$340 million on prescriptions.
"The question now is the legal and health issues involved,"
Floreen said. "You don’t just snap your fingers
and this happens — it’ll take some examination."
According to a document recently released by Health Canada,
the sister agency of the U.S. Food and Drug Administration,
the safety of drugs imported from Canada will not be guaranteed
by Canadian health officials.
William Hubbard, FDA’s Senior Associate Commissioner
for Policy, Planning and Legislation, emphasized the possibility
for counterfeit drugs to make it across the border. In a document
titled "Canada-only importation — the wrong answer
for prescription drug coverage", obtained by The Voice
from PhRMA, Hubbard points out the warning issued by the FDA
concerning prescription drugs from Canada.
The FDA warns that "prescription drugs purchased from
foreign countries generally are not FDA-approved, do not meet
FDA standards, and are not the same as the drugs purchased
in the United States."
In the document, the FDA also emphasizes that prescriptions
from outside the country could be "outdated, contaminated,
counterfeit or contain too much or too little of the active
ingrediant."
Opponents to the Canadian alternative argue that Americans
with prescription drug coverage typically do not pay prices
that exceed prices in Canada, but could become vulnerable
to the unpredictable condition of the imported drugs.
The controversial issue has been addressed by the highest
levels of government, including Congress, which passed the
Medicine Equity and Drug Act of 2000. The Act allows pharmaceuticals
to be imported to the US on three conditions: the approval
of the U.S. Department of Health and Human Services Secretary
Tommy Thompson, the continued safety of the public and a significant
reduction in the cost of covered products to American consumers.
Last September, the U.S. House of Representatives approved
legislation for the creation of a system that would import
FDA-approved drugs from FDA-approved facilities in Canada,
along with seven other nations.
The study approved by the council, Perez said, will be finished
early in 2004.
"That’s the hope," he said. "We need
to get this done. It is critically important."
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